>> Renee: GOOD EVENING.

WELCOME TO "KENTUCKY TONIGHT."

I'M RENEE SHAW.

THANK YOU FOR JOINING US.

OUR TOPIC TONIGHT: COVID, MONKEYPOX, AND THE FLU.

AND POLIO.

COVID DOESN'T GET AS MUCH ATTENTION AS IT ONCE DID, BUT IT'S STILL HERE.

KENTUCKY'S COVID POSITIVITY RATE IS MORE THAN 18% AND 70 OF THE STATE'S 120 COUNTIES ARE IN THE RED ZON.

WHICH MEANS HIGH COVID ACTIVITY.

GOVERNOR ANDY BESHEAR IS URGIN PEOPLE TO GET THE BOOSTER SHOT THAT WILL HELP FIGHT THE LATEST IN ADDITION TO COVID, KENTUCKY NOW HAS 36 CONFIRMED CASES OF MONKEYPOX, BUT THAT'S LESS THAN MANY OF OUR NEIGHBORS.

AND ALL OF THIS COMES AS COOLER WEATHER APPROACHES, MEANING THE RETURN OF FLU SEASON.

SO TO TALK ABOUT ALL OF THIS WE'RE JOINED IN OUR STUDIO BY: ILHEM MESSAOUDI, CHAIR OF THE DEPARTMENT OF MICR IMMUNOLOGY AND MOLECULAR GENETICS AT THE UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE.

DR. MARK DOUGHERTY, AN INFECTIOUS DISEASE SPECIALIST A BAPTIST HEALTH LEXINGTON.

AND DR. FADI AL AKHRASS, MEDICAL DIRECTOR OF INFECTIOUS DISEASE AND INFECTION PREVENTION AT PIKEVILLE MEDICAL CENTER.

WE WANT TO HEAR FROM YOU TONIGH SEND US A QUESTION OR COMMENT O TWITTER AT KYTONIGHTKET.

SEND AN EMAIL TO KYTONIGHT@KET.ORG.

OR USE THE WEB FORM AT KET.ORG/KYT.

BE SURE TO CHECKS THE BOX THAT SAYS YOU'RE NOT A ROBOT.

OR YOU CAN GIVE US A WALL A 1-8 WELCOME TO ALL OUR GUESTS.

WE APPRECIATE ALL BEING LEER TONIGHT.

I WANT TO GO TO THE VERY FIRST THING WE TALKED ABOUT WHICH WAS THE COVID-19 COMMUNITY LEVELS BY COUNTY.

MENTIONED THOSE AT THE VERY TOP OF THE SHOW.

WE'RE GOING BRING UP A MAP THAT SHE IS EXACTLY WHAT WE WERE JUST TALKING ABOUT.

EVERYBODY THERE THERE ARE 12 GREEN COUNTIES.

THERE ARE 38 YELLOW COUNTIES AND 70 RED COUNTIES.

AND YOU SEE THAT DISPLAYED ON YOUR MAP.

AND YOU'LL SEE THAT A LOT OF THOSE RED COUNTIES ARE IN THE EASTERN PART OF STATE.

SO I WANT TO GO TO YOU, DR. DOUGHERTY, AND AND YOU FIRST WHEN YOU SEE THIS MAP, ARE YOU CONCERNED ABOUT THE LEVEL AND RATE OF COVID SPREAD?

>> WELL, I THINK COVID IS EVEN MORE YOU BEEAU BIC YOU WITTED US THAN IT HAS BEEN IN THE PAST.

JUST TALK TO YOUR FAMILY AND FRIENDS.

PEOPLE HAVE GOTTEN IT RAMPANTLY OVER THE LAST FEW WAX.

WE KNOW THAT THE BA5 VARIANT THE PREDOMINANT STRAIN IS INREBEL CREDIBLY CONTAGIOUS.

THE THING THAT'S DIFFERENT, THOUGH, IS WE'RE NOT SEEING NEARLY THE NUMBER OF PATIENTS THAT ARE CRITICALLY ILL IN THE HOSPITALS.

SO JUST TO GET A HANDLE ON THAT, TO PUT SOME NUMBERS ON THAT, TODAY WE HAD ABOUT 25 PATIENTS WITH COVID-19 IN BAPTIST HOSPITAL LEXINGTON AT THE PEAK OF THE DELTA VARIANT SURGE AND THE OMICRON VARIANT SURGE WE HAD 100 MORE PATIENTS THAN THAT, 120 SOMETHING.

WE ALSO HAVE ONLY ABOUT I THINK ONE PATIENT ON THE VENTILATOR WHO HAS OTHER COMPLICATIONS, SO WE DON'T HAVE THE HOSPITALS OVERRUN WITH PATIENTS WHO ARE CRITICAL ILL ON THE VENTILATOR WHERE WE CAN'T PROVIDE SERVICES TO OTHER ILL PATIENTS.

MOST OF THE PATIENTS THAT WE'RE SEEING RIGHT NOW ARE EITHER IMMUNOCOMPROMISED, HAVE OTHER MEDICAL PROBLEMS OR ARE ELDERLY.

AND IN ADDITION TO THAT, MOST OF THE PATIENTS THAT WE'RE SEEING WHO ARE ELDERLY AND HAVE COVID AND IN THE HOSPITAL HAVEN'T HAD BOOSTER DOSES OF THE VACCINE.

SO A LOT OF THEM HAVE HAD THE INITIAL SERIES, THE H. TWO VACCINES AND THEN JUST DIDN'T BOTHER TO GET THEIR FOLLOW-UP DOSES.

IF YOU LOOK AT THE FIGURES IN KENTUCKY, WE SEE THAT 88% OF PEOPLE HAVE HAD THE TWO INITIAL DOSES OF THE VACCINE AND THEN ONLY 62% OF PEOPLE OVER 65 HAVE HAD BOOSTER DOSES.

AND THAT'S WHERE WE'RE SEEING THE MAIN ISSUE WITH PEOPLE GETTING SICK RIGHT NOW.

WE'RE NOT SEEING THE PEOPLE IN THE 30s, 40s, 50s WHO ARE CRITICALLY ILL AND TRYING TO DIE ON US, BUT IT'S REALLY ELDERLY PATIENTS WHO ARE 65, 70, 90 WHO ARE IN THE HOSPITAL WITH COVID AND OTHER SECONDARY CONDITIONS.

>> WHO ARE NOT FULLY VACCINATED, WHICH MEANS THEY HAVEN'T GOTTEN THE BOOSTER.

>> MOST OF WHOM HAVE NOT GOTTEN THE BOOSTER, SO ONE OF THE THING I THINK WE REALLY NEED TO EMPHASIZE WITH WITH THE ADVENT OF NEW VARIANT BOOF SHOTS THAT JUST BECAME AVAILABLE THE IN LAST WEEK THAT YOU JUST INDICATED YOU GOT A FEW DAYS REQUESTING, I THINK WE REALLY NEED TO FOCUS ON PEOPLE WHO HAVE PROBLEMS WITHNER IMMUNE SYSTEM, WHO ARE DEBILITATED, WHO ARE 65 OR OLDER.

THEY NEED TO REALLY PROCEED IN GETTING THOSE BOOSTER SHOTS SOON.

>> SO, DR. FADI, I WANT TO ASK YOU ABOUT THE PIKEVILLE EXPERIENCE.

SO WHAT ARE YOU SEEING?

DO THE NUMBERS KIND OF RESEMBLE THAT OF CENTRAL BAPTIST ANY KNOW IT'S A DIFFICULT POPULATION BUT WHAT YOU ARE SEEING THERE?

>> IT'S ALMOST THE SAPE ACROSS THE WHOLE STATE OF KENTUCKY, BUT IF YOU CAN LOOK AT THE MAP WE STILL HAVE HIGH ACTIVITY IN THE PIKE COUNTY, WE'RE STILL IN THE RED, AND AGAIN THIS IS IS THE BUT OF WOULD MAIN THINGS, NUMBER ONE WANING IMMUNITY BECAUSE THE MARINATE OF THESE PEOPLE GOT VACCINATED A ALONG TIME AGO AND EVENT WITH BOOSTER WE START SEEING WANING I MOOT.

AND NUMBER TWO BECAUSE THE I VERY INFECTION.

IF YOU DO THE EXPLANATION OF MATH, WE ARE TALKING ABOUT MULTIPLICATION BY 10.

IF WE TALK ABOUT THE INCUBATION PERIOD, THIS IS TWO TO THREE DAYS SO IN A VERY SHORT PERIOD OF TOO MANY YOU GET INFECTED BY VIRUS, AND OH TOP OF THAT IT'S HIGHLY INFECTIOUS IN THE UPPER AIRWAY SO IT MULTIPLIES EXPONENTIALLY.

IN THE UPPER AIRWAYS LEADING TO A FAST SPREAD OF THE INFECTION.

PI BELIEVENESS THE TIME AT THIS POINT TO GET OUR IMMUNE BATTERY BOOSTED BECAUSE IT CURRENTLY DWINDLES AWAY, SO THAT'S EXACTLY THE SAME EXAMPLE OF ANY KIND OF CELL PHONE.

IF YOUR BATTERY IS DYING, YOU PLUG IT DIRECTLY INTO THE POWER, AND THIS IS THE SITUATION CURRENTLY WITH OUR IMMUNE SYSTEM.

I BELIEVE IF WE GET THE BIOVARIANT VACCINE WE'LL BE ABLE TO STOP THE SPREAD, AND THIS IS VERY CRITICAL AND WE ARE ABLE AS WELL TO CUT DOWN THE ON DRASTIC OUTCOMES, ESPECIALLY AS DR. DOUGHERTY SAID, IMMUNOCOMPROMISED PEOPLE, THE ELDERLY PEOPLE.

WHEN THEY'RE VERY CRITICAL WHEN IT COME TO IMMUNITY AND CAN LOSE THEIR I MEAN QUICKLY.

CURRENTLY WE STILL SEE INACTIVE AREA.

IN THE HOSPITAL, WE HAVE PATIENTS IN THE HOSPITAL, SOME OF THEM CRITICAL.

THE MAJORITY OF THEM IMMUNOCOMPROMISED.

BUT THE BOTTOM LINE COVID IS STILL HERE, IS LINGERING FOR LONG TIME, AND WE NEED TO TAKE THE FULL PROTECTION ON PROTECT IMMUNITY.

>> DR. MESSAOUDI WANTLESS WEEK I TALKED TO DR. STEVEN STACK THE COMMISSIONER FOR HEALTH, AND HE SAIDY 80 PS WHAT WE'RE SEEING IN THE COVID CASES ARE THE BA 5 VARIANTS AND E SAID IF IT'S BEEN TWO MONTHS SINCE NATURAL INFECTION OR YOUR BOOSTER, IT'S TIME TO GET BOOSTED AGAIN, SO YOU WOULD AGREE WITH THAT ADVICE?

>> ABSOLUTELY.

I THINK IT'S ALMOST 90% OF THE VARIANT IN CIRCULATION RIGHT NOW THE BA.5, AND SO IT'S REALLY GREAT THAT WE HAVE THESE NEW VACCINE AVAILABLE RIGHT NOW THAT INCLUDE THE SPIKE PROTEIN FROM THE VARIANT THAT IS ACTUALLY IN CIRCULATION, NOT ONLY THE VARIANT THAT WAS IN CIRCULATION ALMOST TWO YEARS AGO.

>> AND BOTH PFIZER AND MODERNA HAVE THOSE SHOTS AVAILABLE THAT COVER THE ORIGINAL CORONAVIRUS PLUS THE BA.5.

>> PLUS NAME BY VALENT BOOF.

I WOULD SAD SOMETHING ELSE THAT MY COLLEAGUES HAVE SAID.

WHILE IT'S REALLY IMPORTANT THAT THOSE WHO ARE OOH MOST RISK, IMMUNOCOMPROMISED AND ELDERLY POPULATION GET VACCINATED WEBSITES EQUALLY IMPORTANT, I WOULD ARGUE MORE IMPORTANT FOR THOSE OF US WHO ARE NOT IMMUNOCOMPROMISED TO GET THE VACCINE BECAUSE WE ALL KNOW INDIVIDUALS WHO ARE OLDER THAN 65 YEARS OF AGE WHO HAVE, FOR WHATEVER REASON, A WEAKENED IMMUNE SYSTEM EITHER BECAUSE THEIR IMMUNOSUPPRESSANTS, THEY'VE RECEIVED A TRAN PLANT OR THEY HAVE AN AUTOIMMUNE DISEASE, ET CETERA, THEY CAN GET BOOSTED BUT THEIR IMMUNE SYSTEM WILL NOT GENERATE A REALLY GREAT RESPONSE.

AND SO WE ACTUALLY ALL NEED TO BE SORT OF -- I HATE TO USE THIS CORNY WORD -- BUT WE ALL NEED TO PROVIDE THE FORCE FIELD AROUND THEM, SO IT'S INCREDIBLY IMPORTANT THAT THOSE OF US WHO ARE IMMUNOCOMPETENT, AND GENERAL'S REALLY GOOD IMMUNE RESPONSE GET VACCINATED IN ORDER TO PROTECT THOSE WHO ARE MOST VULNERABLE IN OUR SOCIETY.

>> SO DR. ANTHONY FAUCI, THE PRESIDENT'S MEDICAL ADVISOR, SAID LAST BECOME WEEK OR LAST WE CAN COUNT ON THIS BEING AN ANNUAL EVENT LIKE THE FLU SHOT, AND THEN WE KNOW THAT SOME PEOPLE ARE CHOOSING TO STICK OUT BOTH ARMS AND GET A FLU SHOT IN ONE AND THE BOOSTER IN THE OTHER.

IS THAT ADVISED?

I DIDN'T DO THAT.

I GOT THE BOOSTER BUT AM GOING TO WAIT A COUPLE OF THE WEEKS ON THE FLUE.

DOES IT MATTER.

>> >> IT DOESN'T MATTER.

OUR IMMUNE SYSTEM CAN HANDLE.

ON WEDNESDAY I'M GOING DO GET ONE INTO SHOT IN THE ONE ARM AND THE BOOSTER IN THE OTHER ARM.

MAYBE IN THE SAME ARM.

>> YOU'RE SO BRAVE.

>> WE DO THIS ALL THE TIME.

OUR PEDIATRICIAN POPULATION IS BOOSTED WITH VARIOUS -- OUR IMMUNE SEM HANDLES MICROROBES A DAILY BASIS SO THERE IS NO FEAR GETTING MORE THAN ONE VACCINE AT THE SAME TIME.

>> BUT ANECDOTALLY WE HAVE HEARD SOME PEOPLE WHO HAVE CHOSEN TO GET THEIR BOOST SHOT AND THE FLU SHOT HAVE HAD FLU-LIKE SYSTEMS OR FELT UNWELL THE NEXT DAY, AND THAT COULD COME WITH JUST THE BOOSTER ALONE.

>> THAT THAN THE WOO BE SURPRISING.

I MEAN, SOME PEOPLE HAVE THAT REACTION TO THE FLU VACCINE TOO.

ONE OF THE OTHER THINGS THAT I WANT TO GET BACK TO IS THAT EVEN THOUGH THINGS HAVE SETTLED DOWN WITH COVID TO SOME EXTENT IN TERMS OF CRITICALLY ILL PATIENTS IN THE HOSPITAL, I THINK IF YOU LOOK AT THE DATA, WE'RE STILL HAVING NEARLY 400 PATIENTS A DAY DIE IN THE UNITED STATES.

SO IF THIS IS WHAT WE THINK IS GOING TO BE THE ONGOING SITUATION FOR THE TIME BEING, THAT EQUATES TO 120 TO 140,000 DEATHS A YEAR WHICH IS MUCH MORE THAN THE NORMAL INFLUENZA YEAR, WHICH IS ON THE ORDER OF ANYWHERE FROM 15 TO 70,000 A YEAR DYING, SO THIS IS LIKE MULTIPLES OF A BAD INFLUENZA YEAR ON AN ONGOING BASIS IS WHAT IT LOOKS LIKE, SO IT'S NOT GONE AWAY.

IT'S STILL AN ISSUE EVEN THOUGH WE'RE NO SEEING -- WE'RE SEEING MORE ELDERLY PATIENTS THAN WE WOULD NORMALLY SEE IN SAY AN INFLUENZA SEASON DIE FROM IT.

BUT IT'S AN ONGOING TRAGEDY.

>> I DO WANT TO TALK, DR. FADI, ABOUT THE INFECTIOUS NATURE OF THESE VARIANTS BEFORE BA.5, AND CRIMINAL JUSTICE DR. DOUGHERTY HAD SAID TO THAT EARLIER.

THE DISCUSSION THE LAST TIME WE HAD YOU ALL SMELLED AFTER THE SHOW WE DVR ASSEMBLED, AFTER THE SHOW WE SHOULD HAVE SHOWN BECAUSE IT WAS SO INFORMATIVE ABOUT HOW THIS LINGERS IN THE AIR, AND WE HAD BEEN TOLD AT THE BEGINNING OF CORONAVIRUS, 15 MINUTES EXPOSURE, THAT CAN SET UP AND PUT YOU AT GREATER RISK, BUT WHEN IT COMES TO THESE VARIANT OR SUBVARIANTS THEY'RE A LITTLE HARDER BALL, RIGHT?

THEY PLAY A DIFFERENT GAME AND THEY'RE MORE CONTAGIOUS BECAUSE THERE ARE AERIAL SOULS THAT CAN LINGER IN THE AIR FOR A LONG TIME, CORRECT?

>> THAT'S TRUE, AND THAT'S THE RICK PART OF THE OMICRON ARE THE VARIANTS.

THE OPTIMISTIC FITS VERY WELL THIS PANDEMICS AND ABLE TO SURVIVE BECAUSE IT IS SO EXCELLENT TO TWEAK ITS GENETICS TO BE EIBEL TO SPREAD ALL THE MORE AND FIND DIFFERENT WAYS TO BE TRANSMITTED SUCCESSFULLY FROM ONE TO ANOTHER PERSON.

AND ON TOP OF THAT THE I'M, ITS VARIANTS ARE -- OMICRON, ITS VARIANTS CAPABLE TO EVADE THE IMMUNE SYSTEM.

THIS IS THE IMPORTANT PART OF THE INFECTION IS OMICRON.

EVEN IF YOU GOT 2nd EFFECT FROM A1 OR A2, YOU CAN STILL BET BA.4 AND BA.5.

SO THIS IS TRICKY.

SO NATURAL IMMUNITY EVEN FROM THE ORIGINAL OMICRON DOESN'T PROTECT YOU FROM CONTRACTING THAT VERY VIRULENT VARIANT OR INFECTIOUS VARIANT ON THE BA.4 AND BA.5.

ON THE TOP OF THAT, AS I MENTIONED EARLIER, THAT PATHOGEN AND THESE SUBVARIANTS WILL MULTIPLY EXPONENTIALLY IN THE NASAL CAVITY.

SO IF YOU COUGH, IF YOU SNEEZE, YOU'RE GOING TO GENERATE A LOT OF THESE PARTICLES IN THE AIR, AND SOME OF THEM ARE AEROSOL, SO YOU'LL BE ABLE TO PASS THAT INFECTION QUICKLY AND RAPIDLY FROM ONE PERSON TO ANOTHER PERSON, SO THAT'S WHAT WE SEE A PARADOX INFECTIONS, ALTHOUGH A LOT OF PEOPLE ARE VACCINATED, A LOT OF PEOPLE HAVE BEEN INFECTED BEFORE, AND THAT'S WHY WE ARE IN TREMENDOUS NEED FOR A BOOSTING PROCESS NOW AS I MENTIONED EARLIER.

OUR BATTERY IS CURRENTLY DWINDLING.

WE NEED TO CHARGE THAT TO BE ABLE TO SOLVE THE SPREAD FROM ONE PERSON TO ANOTHER PERSON AND CUT DOWN ON COMPLICATIONS.

>> REBOUND COVID, WHICH I E. DON'T THINK HAD BEEN A LEXICON WHEN LAST WE MET, WITH THAT CAME ABOUT WE LEARNED ABOUT THAT MORE BECAUSE OF PRESIDENT BIDEN'S INTERNS EXPERIENCE AND EVEN THE FIRST LADY OF HAVING MULTIPLE ROUNDS COVID.

WHAT CONCERNS SHOULD WE HAVE ABOUT MULTIPLE EXPOSURES AND REBOUNDS OF THIS?

>> SO YOU CAN HAVE MULTIPLE EXPOSURE TO THE SAME VIRUS AND YOU CAN STILL GET SEVERAL INFECTIONS AS WELL, BUT USUALLY WHEN YOU GET THE INFECTION, YOU'RE GOING TO RECOVER AND SOME PEOPLE, THEY CAN'T HAVE REBOUND IMMUNE SYSTEM HAVE A LITTLE BIT MORE SYMPTOMS, AND SOMETIMES WE SEE THIS WITH PAXLOVID AS WELL.

SO YOU GET THE TREATMENT.

YOU GET ALMOST CURED FROM THE INFECTION, AND THEN A FEW DAYS LATER ON YOU MAY SEE THE VIRUS AS WELL REPLICATING IN THE UPPER AIRWAY.

IF YOU TEST THEM, YOU WILL BASICALLY TEST POSITIVE.

SO THAT REBOUND MECHANISM IS SOMETHING PROBABLY COMMON THAT WE SEE FREQUENTLY AND NOTABLY WITH COVID-19.

SO IT DOESN'T MEAN THAT YOU'RE MORE INFECTIOUS WHEN YOU HAVE THE REBOUND.

NOBODY KNOWS EXACTLY WHAT DOES IT MEAN AND WHAT'S THE SIGNIFICANCE OF HAVING POSITIVE PCR IN THE NASAL CAVITY OR ORAL CAVITY IF YOU RETEST POSITIVE TO COVID.

>> THAT WAS GOING TO BE MY QUESTION THERE.

I WANT TO GO TO YOU, DR. FADI.

SOME PEOPLE COULD TEST POSITIVE FOR MONTHS.

THAT DOESN'T ALWAYS MEAN ANYTHING ABOUT YOUR ABILITY TO BE CONTAGIOUS OR INFECTIOUS.

IT'S JUST YOU'RE A CARRIER?

>> WHEN WE FIRST STARTED TALKING ABOUT SOURCE COVE 2 I LIKE TO DESCRIBE THE GENE NOEMCH THIS VIRUS -- GENOME OF A VIRUS A STRING OF PEARLS SO IF YOU THINK ABOUT THE THREAD GOING THROUGH THE STRING OF PEARLS ARE THE IRAN AND THE PEARLS ARE THIS NUCLEAR PROTEIN THAT PROTECTS PROTECTS THE GENETIC MATERIAL, THIS VIRUS P IF YOU BREAK THE STRING OF PEARLS IT'S NO LONGER A NICE NECKLACE TO WEAR BUT YOU CAN FIND THOSE PEARLS.

THAT'S WHAT THE PCR DOES.

YOU ARE LOOKING FOR A NECKLACE BUT YOU HAVE PILL LITTLE PEARLS THAT ARE NOT PUT TOGETHER.

I THINK THIS IS WHY THE CDC'S GUIDELINES HAVE EVOLVED OVER TIME FOR THE QUARANTINING.

FROM TEN DAS TO FIVE DAYS.

ITS A RAPIDLY CHANGING FIELD, AND WE'RE ADAPTING JUST AS THE VIRUS IS ADAPTING.

>> DO YOU THINK THE CDC GOT IT RIGHT WITH THESE GUIDELINES BECAUSE THEY CAN SEEM A LITTLE CONFUSING.

THESE ARE FROM AUGUST AND IT SEEMS IT HAD COULD BE INTERPRETED A LOT OF DIFFERENT WAYS.

WHEN DO YOU IDENTITY?

FOR HOW LONG?

DO YOU HAVE TO HAVE A NEGATIVE TEST?

WHEN CAN YOU GET IDENTITY HOUSE AND WHEN ARE YOU EXPOSING PEOPLE?

>> WE HAVE TO GIVE THE CDC CREDIT.

THEY'RE TRYING TOO RESPOND TO A SITUATION THAT'S EVOLVING REALLY, REALLY FAST.

>> AND PUBLIC TOLERANCE.

>> YES.

AND COVID FATIGUE, IT'S COMING ON THE HEELS OF KINDS OF A BOTCHED EARLIER RESPONSE IN COVID FATIGUE AND PEOPLE JUST READY TO GET ON WITH LIFE.

BUT I MEAN, IT'S ON THE RISE.

I GET THIS QUESTION, WELL, 1 IF YOU FEEL -- IF YOU FEEL SICK AND YOU TEST POSITIVE, IDENTITY FOR FIVE DAYS, AND -- ISOLATE AND IF YOU WEAR BETTER COME OUT, WEAR A TIGHT FITTING MASKS FOR FIVE DAYS TO PROTECT THOSE AROUND YOU.

IF YOU FEEL SYMPTOMS, PLEASE STAY HOME UNTIL YOU FEEL BETTER.

BUTTED THE NEED FOR TESTING HAS BEEN REMOVED BECAUSE OF THEE LINGERING ANTIGENS AND IRAN PIECES THAT MAY OR MAY NOT MEAN THAT THE PERSON IS HIGHLY INFECTIOUS.

>>Y IS A COUPLE OF GOOD QUESTIONS FROM VIEWERS.

WHAT DO YOU ALL HAVE TO SAY ABOUT NO TESTING ON HUMANS FOR THIS LATEST BOOSTER?

I'LL GO TO YOU FIRST.

>> I WILL.

SO IT'S REALLY INTERESTING TO ME HOW MUCH UP IN ARMS PEOPLE ARE ABOUT THIS.

WE ROLL OUT THE FLU VACCINE EVERY YEAR WITHOUT TESTING IT IN HUMANS AND WE RELY THE ON FACT THAT WE HAVE THIS HISTORY OF MAKING GOOD VACCINES THAT WORK.

THIS IS THE SAME TECHNOLOGY THAT WAS RIGOROUSLY TESTED DURING THE INITIAL ROLL OUT OF THE VACCINE.

IT'S A TWEAKED VERSION OF IT, JUST LIKE WE TWEAK THE INFLUENZA VACCINE EVERY YEAR.

SO IT'S BEEN TESTED.

THE ORIGINAL TECHNOLOGY HAS BEEN VETTED.

THIS HAS BEEN TESTED IN A VERY RIGOROUS ANIMAL MODEL, AND IT'S ROLLED OUT, AND WE'RE GOING TO BE COLLECTING DATA FROM INDIVIDUALS WHO ARE VACCINATED, SO WE WILL HAVE THE DATA, BUT THIS IS NO DIFFERENT THAN THE NEW FLU VACCINE EVERY YEAR.

WE DON'T GO THROUGH MASSIVE CLINICAL TRIALS BECAUSE IF WE DID THAT IT WOULD BE A WHOLE NEW SET OF VIRUSES THAT ARE IN CIRCULATION BY THE TIME THIS HAPPENS.

THIS JUST REQUIRED A VERY QUICK RESPONSE.

>> ANOTHER QUESTION.

WHAT DO YOU HAVE ALL TO SAY ABOUT THE SEVERE SIDE EFFECTS SUCH AS BLOOD CLOTS AND MISS CARRIAGES?

>> I BELIEVE ERR THEY ARE POINTING TO THE THE VACCINE, MRNA VACCINE, SO USUALLY THE PFIZER AND MODERNA THEY DON'T HAVE SUCH COMPLICATIONS LIKE CLOTTING IN THE LOWER EXTREMITY ESPECIALLY IN THE YOUNG FEMALE.

THIS IS MAINLY THE DNA AB ADENOVIRUS DNA TECHNOLOGY WHICH IS WE DON'T USE VERY OFTEN.

WE MAINLY FOCUS ON THE PFIZER AND MODERNA, AND USUALLY THESE VACCINES ARE EXTREMELY SAFE.

WE HAVE LONG BASICALLY NTH MONTHS EXPERIENCES WERE THEM.

WE HAVE USED THEM ON MILLIONS OF PEOPLE.

AND THEY SHOW VERY EFFECT OF, AND THE SAFETY PROFILE IS VERY, VERY REASSURING.

>> I DO WANT TO TALK ABOUT AT HOME TESTS.

WE KNOW THAT THE GOVERNMENT IS GOING TO STOP PROVIDING THOSE, SO I'M CURIOUS ABOUT WHAT DO YOU THINK THAT WILL DO TO COMMUNITY SPREAD IF YOU DON'T HAVE ACCESS TO A TEST.

WILL WE SEE -- WE WON'T EVEN SEE THE NUMBERS, RIGHT?

SO ARE YOU CONCERNED ABOUT THAT?

AND THEN ARE YOU CONCERNED ABOUT THE AKHRASSY OF THESE TESTS?

HOW MANY SHOULD YOU TAKE UNTIL YOU KNOW YOU GOT THE RIGHT ANSWER?

>> I THINK THE TESTS HAVE BEEN USE NFL PREDICTING CONTAGIOUSNESS.

SO THE PCR TEST WHICH DEAFFECTS THE GENETIC MATERIAL OF VIRUS CAN BE POSITIVE FOR THREE MONTHS OR SOMETIMES EVEN MORE.

THAT DOESN'T MEAN NECESSARILY THAT YOU'RE CONTAGIOUS.

THE AT HOME TESTS OR THE ANTIGEN TEST HAS BEEN ESPECIALLY HELPFUL IN DETERMINING WHETHER YOU'RE CONTAGIOUS AT, SAY, FIVE OR SIX DAYS AFTER YOU'VE SYMPTOMATIC.

IF YOU HAVE A NEGATIVE ANTIGEN YOU'RE MUCH LESS LIKELY TO BE CONTAGIOUS TO SOMEONE ELSE.

THE ANTIGEN TEST IN THE EARLY FEW DAYS OF THE OMICRON ILLNESS, SOMETIMES CAN BE NEGATIVE, SO WE'VE CERTAINLY SEEN THE FIRST ONE OR EVEN TWO TESTS BE NEGATIVE IN THE FIRST COUPLE OF DAYSCH ILLNESS AND THEN TURN POSITIVE, SAY, ON THIRD DAY.

SO JUST BECAUSE OF A NEGATIVE INITIAL ANT JEAN TEST DOESN'T NECESSARILY MEAN YOU DON'T HAVE COVID.

ANOTHER THING THAT I WANTED TO MENTION, THERE HAVE BEEN SOME RECENT STUDIES OUT JUST IN THE LAST FEW WEEKS SHOWING THAT WITH THE OMICRON VARIANT, PROBABLY OVER 50% OF PEOPLE HAD SUCH MINIMAL SYMPTOMS THAT'S DIDN'T EVEN KNOW THEY HAD COVID, SO A LOT OF IT'S EITHER ASYMPTOM I CAN OR MINIMALLY SYMPTOMATIC BUT THAT DOESN'T MEAN THEY CAN'T SPREAD IT TO OTHER PEOPLE, SO THAT'S ANOTHER REASON WHY PEOPLE NEED TO PROCEED WITH GETTING THE VARIANT BOOSTER VACCINE DOSE BECAUSE YOU CAN BE OUT AMONG PEOPLE WHO DON'T HAVE A COUGH, DON'T LOOK LIKE THEY'RE SICK, DON'T HAVE FEVERS, AND THEY CAN STILL POTENTIALLY SPREAD IT TO YOU OR YOUR FAMILY MEMBERS.

>> SO IF YOU GET A COVID BOOSTER BUT YET YOU MIGHT HAVE HAD AN EXPOSURE, THERE A DANGER THERE BY PERHAPS BEING COVID POSITIVE AT THE TIME WHEN YOU GET A BOOSTER SHOT?

>> WE REALLY THAN THE SEW SEEN THAT.

WE HAVEN'T SEEN THAT BE AN ISSUE.

AND I DON'T THINK THAT'S A CLINICAL CONCERN.

>> AGREE?

>> ABSOLUTELY.

I THINK ESPECIALLY AT THE BEGINNING WE ENCOURAGE PEOPLE WHO HAD COVID TO WAIT THREE MONTHS BEFORE THEY GOT VACCINATED BUT THAT IS WAS MORE OF A PUBLIC HEALTH DOSE SPARING TYPE OF APPROACH.

IF YOU JUST HAD COVID, YOU'RE PROBABLY GOING TO BE OKAY FOR THE NEXT COUPLE MONTHS.

LET'S MAKE SURE PEOPLE WHO HAVE NOT GOTTEN VACCINATED.

BUT THAT'S NOT AN ISSUE ANYMORE BECAUSE I THINK OUR SUPPLY REALLY EXCEEDS ACTUALLY THE DEMAND FOR VACCINES AT THIS MOMENT.

>> AND YOUR ANTIBODIES WOULD BE THROUGH THE ROOF, RIGHT, IF THAT WERE THE CASE PERHAPS.

>> YES.

>> ANY CONCERNS ABOUT THESE AT HOME TESTS, ABOUT THE EFFICACY OF THEM OR HOW FREQUENTLY YOU SHOULD TAKE THEM, HOW LONG YOU SHOULD TAKE THEM?

SO IF IT'S THE THIRD DAY, THE FIFTH DAY.

IF YOU'RE ASYMPTOM I CANNOT BUT YOU HAD AN EXPOSURE, HOW LONG SHOULD YOU CONTINUE TO TESTSOME.

>> I COMPLETELY WHOLEHEARTEDLY AGREE WITH MARK.

I WOULD SAY THE AT HOME ANTIGEN TESTS ARE GREAT WHEN YOU'RE SYMPTOMATIC AND YOU WANT KNOW IS THIS COVID, IS THIS THE FLU.

FIRST OF ALL IF YOU ARE REALLY THAT SICK YOU SHOULD STAY HOME.

IF YOU WANT KNOW IF IT'S ALLERGIES.

I JUST MOVED HERE FROM CALIFORNIA TEN MONTHS AGO AND I -- >> WELCOME TO THE BLUEGRASS ALLERGIES.

>> BUT IF YOU ARE VERY SYMPTOMATIC, AN ANTIGEN TEST IS A GREAT WAY TO DIFFERENTIATE THAT.

IF YOU HAD JUST HAD A EXPOSURE AND YOU'RE ASYMPTOMATIC ANTIGEN TEST IT DOESN'T MEAN ANYTHING.

IF YOU HAVE AM IS TOIC AND TESTED POSITIVE AND ISOLATED FOR FIVE DAYS, YOU WANT TO BE EXTRA CAUTIOUS BEFORE COMING OUT INTO SOCIETY.

THAT'S ANOTHER GOOD TIME TO TEST AND THEN COME OUT.

BUT I WOULD SAY THAT IF THE ANTIGEN TESTS ARE BEST WHEN YOU HAVE SYMPTOMS AND THERE'S ENOUGH ANTIGEN BEING MADE TO ACTUALLY DETECT IT.

>> SO GENERAL QUESTION, DR. FADI.

HAVE WE WITH THE VACCINES CAUGHT UP TO THE VIRUS?

>> I THINK WE'RE THE IN PROCESS.

THAT'S WHY THIS IS DYNAMIC AND FLUID SITUATION, AND YOU NEED TO TWEAK YOUR VACCINE AND YOUR INFECTION PREVENTION AND FUNDAMENT ALZHEIMER'S FOR PREVENTION TO BE -- FUNDAMENTALS FOR PREVENTION TO BE ABLE TO BE ON TOP OF THE SPREAD AND CONTAIN THE PANDEMIC, SO THIS HAS BEEN A ROUGH TWO, THREE YEARS.

I TOTALLY AGREE WITH THAT.

BUT UNFORTUNATELY ALL THESE 7:00 AND THESE TECHNOLOGIES, INVENTIONS AND THESE TECHNOLOGIES AND BEING ON TOP OF THE VIRUS WILL TAKE SOME TIME, ESPECIALLY WHEN YOU DEAL WITH A VERY SMART VIRUS.

THAT VIRUS IS VERY SMART.

IT CAN TWEAK GENETIC MATERIAL VERY QUICKLY.

THAT'S WHY WE SAY THE OMICRON IS FITTING THE PANDEMIC VERY WELL.

SO IT'S AN EXCELLENT EVADER OF THE IMMUNE SYSTEM SO WE HAVE TO DO MORE WORK TO BE ABLE TO BE ON THE TOP OF THE VIRUS, AND TO THE BOTTOM LINE NOBODY IS SAFE UNTIL EVERYBODY IS SAFE, AND AS EVERYBODY SAID HERE, SOME PEOPLE UNFORTUNATELY, THEY ARE FULL OFY DEPENDENT ON OUR IMMUNITY TO BE PROTECTED.

SO WE NEED TO KEEP -- AND AGAIN ONE MORE TIME, BOOSTING THE NEW SYSTEM, TRYING TO GET A LITTLE BIT MORE IMMUNITY AGAINST THE OMICRON BA.5 MAINLY IS VERY CRITICAL IS TO STOP IS THE SPREAD.

THIS IS HOW YOU BUILD THE IMMUNOGLOBULIN MAINLY IN YOUR NASAL CAVITY, IN YOUR IMMUNE SYSTEM.

>> HAVE WE REACHED HERD IMMUNE?

DO WE EVEN KNOW WHAT THAT IS ANYMORE?

IS IT A MOVING TARGET?

>> THE HERD IMMUNITY IS ACHIEVABLE WHEN YOU HAVE A TARGET, WHICH IS BASED ON REPRODUCTIVE NUMBER, SO USUALLY YOU NEED ONE MINUS 1 OVER THE -- WHICH IS PROTECTIVE OF THE IMMUNITY AND UNFORTUNATELY THAT NUMBER IS CHANGING CONSTANTLY SO DINE I CAN IN TOTE POINT EVEN, EVEN IF YOU REACH THAT GOAL AND YOU HAVE A VIRUS COMPLETELY EVADING THAT IMMUNE SYSTEM, YOU NEED TO SWITCH THE WHOLE BALLGAME AGAIN AND TRY TO MOVE TO DIFFERENT SETTING FOR HERD IMMUNE.

SO I CANNOT TALK ABOUT HERD IMMUNITY AT THIS POINT ABUSE IT'S A VERY FLUID SITUATION.

>> YEAH.

DO YOU AGREE?

>> 100%.

AND I JUST WANT TO CLARIFY ONE THING.

SO WHEN WE'RE TALKING WITH IMMUNE, WE'RE TALKING ABOUT THE IMMUNITY THAT WAS GENERATED TO A PREVIOUS VARIANT, AND IT'S NOT COMPLETELY UNEXPECTED.

IT'S AN IRAN VIRUS.

EVEN THOBE RNA.

EVEN THOUGH IT'S BIG IN THE WORLD OF RNA VIRUSES, IT'S BIG AND CLINK COMPARED TO OTHER RNA VIRUSES, THINK INFLUENZA AGAIN WE'RE GOING TO TALK ABOUT FLU, YOU HAVE A FEVER, WEST NILE OR SEEK A, THESE VIRUSES ARE VERY SMALL AND VERY NIMBLE AND THIS VIRUS JUMPED FROM ONE SPECIES INTO HUMANS THREE YEARS AGO, AND IT'S JUST LEARNING TO ADAPT TO ITS NEW HOST, SO THOSE THINGS ARE EXPECTED.

>> AND THERE ARE PROBABLY HUNDREDS IF NOT THOUSANDS OF VARIANTS OUT THERE JUST LURKING, RIGHT?

>> THAT'S WHY WE CALL THESE VARIANTS OF CONCERN.

THAT'S WHY WE STRATEGICALLY CALL THEM VARIANTS OF CONCERN BECAUSE THESE ARE THE VARIANTS THAT WE'RE MOST WORRIED ABOUT.

BUT, YES, THERE'S A LOT OF VARIANTS OUT THERE.

>> BUT DO THE VARIANTS WEAKEN BASED ON THE NUMBERS OF THOSE WHO HAVE BEEN BOOSTED AND WHO HAVE WHO ARE PROVIDING SOME OF THIS PROTECTION TO OTHERS EITHER THROUGH NATURAL INFECTION OR BOOSTING, VACCINATIONS ARE ON BOTH, A COMBINATION THEREOF?

>> ABSOLUTELY.

I MOVED HERE FROM CALIFORNIA SO WE USE A LOT OF FIRE ANALOGIES COMING FROM CALIFORNIA, BUT THIS IS CREATING FIRE BREAKS.

THIS IS CREATING TRENCHES, DUMPING WATER.

WHEN THE VIRUS FIRST LANDED INTO HUMAN POPULATION, IT WAS LIKE SOMEBODY PUTTING A MATCH IN A REALLY DRY FIELD.

THERE IS NOTHING TO STOP THIS FIRE FROM SPREADING.

BUT WITH VACCINES, WITH ANTIVIRALS, MONO CORONAL WAS EVERY ONE OF THESE TOOLS IS BUILDINGS A TRENCH OR A FIRE RETARDANT TYPE OF APPROACH TO IT.

THE MORE TOOLS WE HAVE AND TRENCHES WE HAVE, THE MORE CONTAINED IT'S GOING TO BE.

>> AND YOU BELIEVE THAT WE WILL BE GETTING A COVID BOOSTER -- WILL IT STILL BE CALLED A COVID BOOSTER IF YOU DO IT EVERY YEAR.

>> >> AN ANNUAL COVID SHOT.

>> AN ANNUAL COVID SHOT JUST LIKE WE DO WITH THE FLU, RIGHT.

>> >> THIS MIGHT BE OUR NEW REALITY.

>> WE TALKED ABOUT REBOUND.

I DO WANT TO TALKING ABOUT LONG COVID.

I DON'T THINK WE GOT A CHANCE TO TALK WITH THIS LAST TIME.

I SEE ON IT FACEBOOK, FOLKS WHO HAVE HAD SEVERAL WITHOUT BOUTS OF COVID, TALKING ABOUT HOW MANY LINGER SIDE EFFECTS WHETHER IT'S THE BRAIN FOG OR IT MIGHT NEUROLOGICAL THINGS THAT THEY THINK ARE A LITTLE OFF.

WHAT DO WE KNOW ABOUT LONG COVID AND HOW IT CAN BE REVERSED OR IS IT?

>> WELL, WE KNOW THAT IT CAN PARTIALLY REVERSE OVER TIME.

WE DON'T HAVE A REAL GOOD HANDLE ON LONG COVID BECAUSE THERE'S NOT A PRECISE DEFINITION.

IT'S ANY KIND OF LINGERING SYMPTOMS THAT CAN LAST AFTER YOUR -- AFTER YOU HAD THE INFECTION.

WE KNOW THAT MOST VIRAL INFECTIONS HAVE A POST VIRAL SYNDROME.

YOU DON'T -- YOU FEEL FATIGUED.

YOU DON'T FEEL BACK TO NORMAL.

BUT IN GENERAL YOU RECOVER OVER THE COURSE OF TWO TO THREE WEEKS.

WITH COVID, HOWEVER, IT'S ESTIMATED THAT UP TO 40% OF PEOPLE MAY HAVE SOME TYPE OF SYMPTOMS AND DON'T FEEL WELL FOR VERY EXTENDED PERIODS OF TIME, MEANING OVER THREE MONTHS.

AND IF YOU LOOK AT THE DATA ON EMPLOYMENT EVEN, WE CAN SEE THAT IT'S ESTIMATED -- SOME DATA CAME OUT THIS WEEK SHOWING THAT WE PROBABLY HAVE 500,000 PEOPLE OUT OF THE WORKFORCE BECAUSE OF LINGERING SYMPTOMS OF COVID.

THAT'S A HUGE NUMBER, AND THAT HAS A BIG IMPACT ON THE INDIVIDUALS THAT IT'S AFFECTING AND A BIG IMPACT ON OUR ECONOMY TOO.

THE SYMPTOMS CAN VARY FROM HAVING PERSISTENT LOSS OF TASTE AND SMELL, HAVING ABNORMAL TASTE WHERE YOU EAT A PIECE OF MEAT AND IT JUST TASTES HORRIBLE AND YOU DON'T EVER WANT TO HAVE THAT AGAIN.

IT CAN BE FATIGUE TO THE POINT THAT YOU CAN'T EXERCISE, YOU CAN'T GO UP THE STAIRS, YOU CAN'T RETURN TO WORK.

SO IT IS HAVING A HUGE IMPACT ON A LARGE NUMBER OF PEOPLE.

>> LIFE HAVE LIFE-THREATENING IN ANY WAY?

>> I THINK MOST OF IT'S NOT LIFE-THREATENING BUT IT'S LIFE-ALTERING.

>> LIFE-ALTERING.

I DID WANT TO MENTION A COUPLE THINGS ABOUT REBOUND.

SO ANOTHER REASON THAT WE'RE NOT SEEING AS MANY HOSPITALIZATIONS AND AS MANY PEOPLE BECOMING SEVERELY ILL IS THE TREATMENTS THAT WE'RE GIVING, THE PAXLOVID IN PARTICULAR.

I THINK IT'S SORT OF FASCINATING THAT BOTH OF THE BIDEN'S AND DR. FAUCI GOT REBOUND COVID.

ONE OF THE IMPORTANT THINGS TO REMEMBER THERE, THOUGH, IS THAT EVEN IF YOU DEVELOP REBOUND AFTER HAVING TAKEN PAXLOVID, WE'RE NOT SEEING PEOPLE GET CRITICALLY ILL AND GET ADMITTED TO THE HOSPITAL.

THE REBOUND COVID CASES, YES, THEY'RE -- PEOPLE FEEL POORLY.

THEY MAY HAVE FEVERS EVEN, AND HAVE FATIGUE, BUT WE'RE NOT SEEING PEOPLE GET CRITICALLY ILL AFTER HAVING REBOUND WHEN THEY'VE TAKEN PAXLOVID.

NOW, THE LAST TIME THAT WE MET, WE HAD AFFIDAVIT ON PAXLOVID SHOWING THAT IT WORKED IN THE UNVACCINATED.

THAT'S WHAT THE FIRST STUDIES WERE.

WE NOW KNOW THERE'S GOOD DATA SHOWING THAT IN THE PATIENTS WHO WERE VACCINATED OR HAVE HAD PREVIOUS COVID WHO ARE AT HIGHERS RISK FOR DEVELOPING SEVERE DISEASE THAT I PREVENT HOSPITALIZATION AND LOWER MORTALITY AND IT PREVENTS ALL COUNTIES ARE OTHER COMPLICATIONS.

SO IF YOU'RE SICK FROM COVID AND YOU HAVE RISK FACTORS FROM NOT DOING WELL, BEING OVERWEIGHT, HAVING LUNG DISEASE, HAVING HEART DISEASE, BEING OVER 50, HAVING KIDNEY DISEASE, VAG ASTHMA, THOSE ARE ALL REASONS TO SEEK TREATMENT IN AN EXPEDITIOUS FASHION, AND BY THAT I MEAN WITHIN THE FIRST FIVE DAYS OF SYMPTOMS.

NOW, YOU DO HAVE TO CHECK AND MAKE SURE THAT YOU DO NOT HAVE -- YOU'RE NOT ON MEDICATIONS THAT CAN INTERACT WITH PAXLOVID, SO SOME PEOPLE WILL NOT BE ABLE TO TAKE IT BECAUSE THEY'RE ON MOST THOSE MEDICATIONS.

BUT OTHER THAN THAT IF YOU'RE IN THOSE RISK CATEGORIES, I THINK IT'S GUIDE IDEA TO SEEK -- >> CHILDREN, TEENS?

>> IT CAN BE GIVEN IN YOUNGER PEOPLE, BUT, YOU KNOW, THAT COULD BE UNCOMMON UNLESS THEY'RE AT VERY HIGH-RISK OF PROGRESSION.

>> ANYTHING ELSE ON THAT?

>> THERE IS DATA THAT THE DOCTOR ALSO POINTED AT IS VERY REASSURING, SO EACH A VACCINATED INDIVIDUAL IF YOU GET THE PAXLOVID, GOING TO THE HOSPITAL IS LESS THAN 1% AND THIS IS EXTREMELY REMARKABLE SO CURRENTLY WE'RE IN A GREAT POSITION COMPARED TO A FEW YEARS AGO.

WE HAVE MEDICS, A VERY STRONG MEDICATION THAT CAN KNOCK DOWN THE SEVERITY OF DISEASE AND CUT DOWN THE ON RISK GOING TO THE HOSPITAL BY LESS THAN.

1%.

>> SO YOU CAN GET THAT INTO YOUR DOCTOR'S OFFICE.

>> ABSOLUTELY.

THIS IS AS A BASICALLY A PRESCRIPTION FROM THE DOCTOR'S OFFICE.

>> GREAT.

WANT TO TALK ABOUT THE FLU?

>> LET'S TALK ABOUT FLU.

>> LET'S TALK ABOUT FLU.

ONE OF THE THINGS DR. STACK HOLD US LAST WEEK WAS BECAUSE OF ALL THE MITIGATION MEASURES WE'VE BEEN PRACTICING WITH MASK AND SOCIAL DISTANCING THAT WE MIGHT ACTUALLY SEE A GREATER UPTICK OF FLU INCIDENCE BECAUSE WE HAVE HAD A PRETTY GOOD RUN IS FLU NUMBERS THE LAST COUPLE OF YEARS BECAUSE OF ALL OF THE MITIGATION MEASURES WE'VE BEEN DOING, SO HOW DO YOU SEE THIS FLU SEASON?

WE KNOW THAT AUSTRALIA HAD ITS WORST FLU SEASON IN FIVE YEARS.

HOW DOES THAT BODE FOR THE UNITED STATES?

>> YEAH, I'M A LITTLE WORRIED BECAUSE EVEN THE FLU SEASON LAST YEAR LASTED, WE SAW TWO PEAKS.

IT WAS A PEAK EXPECTED AROUND THE END OF DECEMBER AND THEN THERE I WAS SECOND PEAK IN JUNE, SO THIS IS -- NEACE UNUSUAL, JUST -- NEACE UNUSUAL, JUST A LINGERING LONG SEASON WITH TWO PEAKS AND I THINK IT HAS TO DO AGAIN WITH PEOPLE FEELING THAT THEY WOULD LIKE TO GET ON WITH LIFE AGAIN.

THEY'VE 17 INACTION VATED.

THEIR KIDS ARE VACCINATED.

THEY'RE TAKING THE VACATION THEY HAVE DEFERRED FOR A COUPLE OF YEARS.

PEOPLE ARE GOING ON THEIR HONEYMOON FOR THE FIRST TIME IF THEY GOT MARRIED IN 2019, 2020 WITH, SO THIS IS NOT SURPRISING AND I THINK WE'RE GOING TO SEE MORE CASES THIS YEAR.

FOR SURE.

>> AND GETTING THE SHOT WITHOUT A DOUBT, JUST DO IT.

>> JUST DO IT.

>> HOE IS IT NOT FOR?

ARE THERE PEOPLE WHO ARE NOT GOOD CANDIDATES FOR THE FLU SHOT?

ANY?

>> EVERYBODY SIX MONTHS AND OLDER CAN GET THE FLU SHOT.

>> IF YOU'RE SIX MONTHS AND OLDER YOU CAN GET A FLU SHOT.

>> SO YOU MAY HAVE SOME SIDE EFFECTS FROM A FLU SHOT DUTY BUT THAT DOESN'T MEAN YOU GOT THE FLU FROM THE FLU SHOT BE, RIGHT?

>> THIS IS SMALL IN REGARDS OF HAVING COMPLICATION FROM INFECTION, EVEN SPREADING THE INFECTION TO OTHERS, BUT IF YOU LOOK AT THE ACTIVITY OF INFLUENZA LAST YEAR, IT'S I THINK AROUND 4% -- CORRECT ME IF I'M WRONG -- BUT THIS IS AN UPTICK FROM THE YEAR ARE BEFORE, SO WE SEE CONSTANT INCREASE IN THE POSITIVITY OF THE FLU, AND CURRENTLY ALMOST LIFTED ALL THE MITIGATION MEASURES, SO I DON'T KNOW EXACTLY WHAT'S GOING TO HAPPEN THIS YEAR, SO THE ACTIVITY COULD BE HIGHER.

THE FLOOD COULD COME WITH A LITTLE BIT OF VENGEANCE THIS YEAR.

I HAVE NO IDEA.

THAT'S WHY WE NEED TO BE VERY CAUTIOUS, TRY TO TAKE ALL THE BASIC FUND AMEND HALT WHEN IT COMES TO PRECAUTION.

GET VACCINATED.

WASH OUR HANDS.

TRY TO COVER OUR NOSE AND OUR MOUTHS WHEN WE COIF AND SNEEZE.

LET'S TAKE THE BASIC MEASURES TO PREVENT THE SPREAD OF THE INFECTION.

EVERYBODY IS QUALIFIED TO TAKE THE VACCINE TO BE ABLE TO BE PROTECTED FROM THE FLU AND SPREADING THE FLU TO OTHERS.

>> THE OPTIMAL TIME TO TAKE THE FLU SHOT IS WHEN?

RIGHT NOW OR WAIT UNTIL OCTOBER, NOVEMBER?

>> THE OPERATED MAL TIME TO TAKE THE FLU WHO THE IS WHEN THE FLU SHOT BECOMES AVAILABLE.

>> AND IT LASTS FOR HOW LONG ARE YOU GOOD?

>> YOU'RE GOOD UNTIL THE NEXT YEAR WHEN YOU HAVE A NEW FORMULATION, DEPENDING ON WHAT HAPPENED IN SOUTHERN HEMISPHERE.

>> OKAY.

ANYTHING ELSE YOU WITH AN ON TO ADD ONTO THAT DR. DOUBTERY?

>> I'VE BEEN AN INFECTIOUS DISEASE DOCTOR 35 YEARS, AND THE LAST TWO YEARS HAVE BEEN THE MOST MINIMAL INFLUENZA SEASON THAT I'VE EVER SEEN.

SO THAT KIND OF BODES POORLY FOR WHAT'S COMING UP THIS WINNER I THINK BECAUSES MOW PEOPLE WON'T HAVE BEEN EXPOSED, THEY DON'T HAVE IMMUNE, IMMUNITY WANES, AND IF YOU LOOK AT WHAT'S HAPPENED IN THE SOUTHERN HEMISPHERE AS WE'VE ALREADY ALLUDED TO, THAT USUALLY BODES WHAT'S GOING TO HAPPEN TO US THE FOLLOWING WINTER.

AND A LOT OF THE SOUTHERN HEMISPHERE, ESPECIALLY AUSTRALIA, HAD A REALLY BAD YEAR THIS YEAR.

SO I THINK WE'RE GOING TO SEE A SURGE IN INFLUENZA.

IDEALLY, IF YOU SAID WHEN SHOULD I -- WHEN WOULD BE THE VERY BEST TIME FOR ME TO GET AN INFLUENZA VACCINE, IT'S PROBABLY -- IT'S PROBABLY GOING TO BE ON AVERAGE IN THE END OF OCTOBER, BEGINNING OF NOVEMBER, BECAUSE THE VACCINE DOES START, THE IMMUNE DOES START TO FADE SOMEWHAT AFTER FOUR MONTHS AND SOME OF MY PATIENTS WHO ARE RELATIVELY MENU OH SUPPRESSED OR MAY NOT HAVE RESPONDED WELL TO THE VACCINE I GIVE A SECOND DOSE IN JANUARY OR SOME TIME IN JANUARY, EARLY FEBRUARY, ABOUT IT REALLY DEPENDS ON THE DYNAMICS EFFLUENT SEASON.

SIMONS HAVE WE HAVE AN EARLY INFLUENZA SEASON SO IF YOU SEE CASES ARE STARTING TO GO UP IN THE NEXT COUPLE OF WEEKS, GET THE VACCINE NOW.

THE IF WE SEE THAT THE CASES ARE STILL SOMEWHAT LOW AND YOU HAVE THE OPTION TO WAIT A LITTLE BIT, YOU MAY WAIT UNTIL SOME TIME IN LATE OCTOBER, EARLY NOVEMBER.

>> OKAY.

GOOD ADVICE.

IS THAT ALL ON FLU?

>> I AGREE WITH THAT.

>> OKAY.

MONKEYPOX.

I KNOW THIS IS DR. MESSAOUDI EAST FAVORITE SO I'M GOING TO YOU ZAWAHRI ABOUT MONKEYPOX.

WE'VE TALKED ABOUT TO YOU BEFORE ABOUT OUR "KENTUCKY EDITION" SO I WITH AN YOU TO GIVE AS YOU BASIC PRIMER ON WHAT IT IS, WHERE I COMES FROM AND, AND WHY IT IS IT NOT CLASSIFIED A SEXUALLY TRANS MISSABLE DISEASE?

>> A LOT QUESTIONS TOWN PACK.

MONKEYPOX IS A VIRAL DISEASE.

IT'S CAUSED BY MONKEYPOX VIRUS WHICH IS A MEMBER OF THE ORTHOPOX FAMILY.

IT'S A DISTANT COUSIN TO SMALLPOX.

BUT UNLIKE SMALLPOX, IAN THOUGH THERE ARE TWO -- OF MONKEYPOX, THERE IS A CENTRAL AFRICAN AND AL SOUTHERN AFRICAN BOTH OF THOSE LADIES CAUSE LESS ACTIVITY WE HAVE SEEN IN THE PAST WITH SMALLPOX SO SMALLPOX AROUND 40% MORTALITY.

IF YOU LOOK A WEST AFTER CAN'T, THEN YOU'RE LOOKING AT 10% AND -- SORRY -- THE CENTRAL AFRICAN IS 10% AND SOUTHERN AFRICAN IS 40%.

SMALLPOX HAS BEEN ERADICATED SINCE 19 VACCINE, SORRY, BUT MONKEYPOX IS ENDEMIC, HAS BEEN ENDEMIC IN THE DEMOCRATIC REPUBLIC OF CONGO AND HAS BEEN VERY QUIETLY SPREADING TO ADJACENT COUNTRIES AND THE NUMBERS HAVE BEEN STEADILY INCREASING, THE NUMBER OF CASES OF SMALLPOX -- OF MONKEYPOX HAVE BEEN STEADILY INCREASING SINCE 2017.

THERE'S BEEN A LOT OF OUTBREAKS IN ADJACENT YIS.

THE NUMBERS HAVE BEEN INCREASING AND THERE'S BEEN SOME REALLY GREAT GENETIC STUDIES THAT HAVE SHOWN THAT ACTUALLY THE MONKEYPOX STRAINS THAT ARE IN CIRCULATION RIGHT NOW IN THIS 2022 OUTBREAK ARE PRETTY MUCH THE SAME STRAINS THAT WERE IDENTIFIED IN NIGERIA IN 2017.

AND SO IT'S BEEN THIS SMOULDERING -- I HATE THE TO USE THE FIRE ANALOGY AGAIN -- BUT IT'S BEEN A SMOULDERRING FIRE FORE A NUMBER OF YEARS AND THE CESSATION OF SMALLPOX VACCINATION BECAUSE WE DID ED RA KATE VACCINES.

ADD TO THAT LACK OF VACCINES IN THE AREAS NEEDED THE MOST, THIS WAS LIKE AN OR ANISM THAT WAS A D. ANEURISM THAT WAS A TICKING TIME BOMB.

>> WE'RE SEEING IN IT POPULATIONS AND IT SEEMS TO BE PREDOMINANTLY IN A CERTAIN POPULATION THAT IT'S NOT CLASSIFIED A SEXUALLY TRANSMISSION.

>> SMALLPOX IS SPREAD BY CONTACT WITH THE LESIONS.

THESE LESIONS LOOK LIKE BLISTERS.

THE FLUID INSIDE THOSE MUSTERS IS CHOC FULL OF VIRUS.

IT CAN ALSO BE TRANSMITTED VIA CONTACT WITH SOILED BEDDING OR SURFACES THAT HAVE BEEN TOUCHED, AS WELL AS RESPIRATORY BLOCK LISTS BECAUSE THESE SOURCES CAN ALSO APPEAR IN THE MOUTH SO IF SOMEBODY IS COUGHING OR KISSING, THEN THE VIRUS CAN BE TRANSMITTED THAT WAY ATOP SPO THE PRIMARY MODE OF TRANSMISSION IS SKIN-TO-SKIN CONTACT, WHICH OBVIOUSLY CAN OCCUR DURING INTIMATE CONTACT.

SO THIS PARTICULAR OUTBREAK IN 2022, ESPECIALLY AT THE BEGINNING, 97% OF THE CASES WERE AMONGST MEN WHO HAVE SEX WITH MEN AND IS PEOPLE WERE VERY CONFUSED.

I THINK THERE WAS A LOT OF -- I THINK BLENDERS WITH MESSAGING, AND I THINK IT'S JUST REALLY -- WE HAVE TO BE VERY CAREFUL ABOUT HOW WE THINK THEE THINGS.

EVEN THOUGH WILL WAS A POPULATION WHERE THIS PARTICULAR OUTBREAK IMPACTED DRAMATICALLY, WE NEED TO REMEMBER THAT THIS VIRUS IS NOT LIMITED TO THIS PARTICULAR COMMUNITY.

THIS VIRUS CAN IMPACT ANYONE.

HOUSEHOLD MEMBERS WHO CARE FOR SOMEBODY WHOSE MONKEYPOX WILL BE AT RISK OF CONTRACTING MONKEYPOX.

BUT IT'S -- SO IT'S NOTE CLASSIFIED AS A SEXUALLY TRANSMITTED DISEASE, BUT OBVIOUSLY 52 IF SOMETHING IS SPREAD VIA INTIMATE SKIN-TO-SKIN CONTACT, THEN THAT DOES INCLUDE SEXUAL ACTIVITY, AND THAT IS HOW THIS VIRUS IS ABLE TO SPREAD.

>> I'M JUST THINKING ABOUT THIS CAME INTO NEWS ABOUT THE TIME PEOPLE WERE MOVING INTO DORMITORIES AND COMMINGLING, AND SO DR. FADI, I'M CURIOUS ABOUT YOUR PERSPECTIVE ABOUT HOW YOU UNIVERSITIES OR COLLEGE ENVIRONMENTS MIGHT BE RIPE ENVIRONMENT FOR THE SPREAD OF MONKEYPOX.

>> I DON'T KNOW WHAT TO SAY BUT, OH, BOY, THIS IS ANOTHER FIGHT AND THIS IS ANOTHER PUBLIC HEALTH EMERGENCY, AND IT SEEMS LIKE WE DON'T HAVE TIME TO CATCH OUR BREATH.

>> RIGHT.

>> BUT I THINK THE BOTTOM LINE IS THIS IS A DNA VIRUS.

IT'S A LITTLE BIT MORE STABLE THAN THE TWO VIRUSES I JUST MENTIONED EARLIER, THE COVID-19 AND THE FLU, BUT WE HAVE TO KEEP IN MIND SOME OF THE UNKNOWNS BECAUSE WE DON'T KNOW THE TRUE, THE FULL STORY ABOUT THE MONKEYPOX.

WE DON'T KNOW ABOUT THE POSSIBILITY OF THAT VIRUS EVEN IF IT'S GOING TO MUTATE, IT'S GOING TO FORM ANOTHER VIRUS.

I DON'T KNOW IF THAT VIRUS IS GOING TO CHANGE ITS DYNAMICS AND CHANGE THE MODE OF TRANSMISSION.

CURRENTLY IT'S MAINLY INTIMATE SKIN CONTACT.

IT COULD BE LATER ON BLOOD-BORNE TRANS POLICE.

SO NOBODY KNOWS THE DETAILS.

HOPEFULLY NOT BUT NOBODY KNOWS THE DETAILS SO WE HAVE TO BE VERY VIGILANT AROUND IT.

BUTTED FOR SURE WEAR NIGH A MUCH BETTER POSITION THAN COVID BECAUSE WE ARE ABLE TO CALL THE FIRE DEPARTMENT -- BECAUSE SHE'S TALKING ABOUT FIRE -- VERY EARLY BEFORE THE FIRE IS COMPLETELY OUT OF CONTROL, AND WE ARE CURRENTLY IN A VERY, VERY GOOD POSITION BECAUSE WE HAVE THE TOOLS AND WE HAVE THE KNOWLEDGE IN OUR DISPOSAL TO FIGHT THE MONKEYPOX.

NUMBER ONE, WE HAVE KNOWN MOANING POX FOR MANY YEARS SO WE HAVE DATA AND STUDIES AND EXPERIENCE WITH MONKEYPOX.

NUMBER TWO, WE ARE ABLE TO IDENTIFY THE MODE OF TRANSPORTATION INDIRECTLY WHICH IS INTIMATE SKIN CONTACT.

AND NUMBER THREE, WE HAVE AVAILABLE VACCINE IMMEDIATELY IN OUR HANDS.

IF THEY ARE APPROVED, ALL THESE ARE ADD ADVANTAGEOUS FOR ELIMINATION AND PATROL OF THE MONKEYPOX.

BUT 2022 IS VERY TRICKY AND BASICALLY THE ATIP CALS ARE THE NAME OF THE GAME BECAUSE SIMONS WE SEE A RASH WITHOUT FEVER OR BE VOTING ON THINGS HAVE BEFORE THE ONSET OF FEVER AND SIMONS WE SEE JUST FEW LESIONS CONCENTRATED ON THE GENITALS.

SOMETIMES WE SEE ATYPICAL SKIN MANIFESTATIONS, AND THAT'S BASICALLY THE TRICKY PART, AND PHYSICIANS AND PROVIDERS SHOULD BE VERY EDUCATED ABOUT THESE ASPECTS TO BE ABLE TO TAKE CARE OF FOLKS.

SO INTERNAL WE ARE DEFINITELY LEADING THE WORLD IN THE NUMBER OF MONKEYPOX AND WE SEE THE NUMBER OF CASES COMING DOWN THIS IS BECAUSE WE ARE PUSHING THE VACCINE.

I THINK AWARENESS OVER ANXIETY IS VERY IMPORTANT.

KNOWLEDGE AND EDUCATION OF THE PUBLIC IS EXTREMELY IMPORTANT BECAUSE THESE INFECTIONS ARE MOST INFECTIOUS WHEN THESE FOLKS ARE MOST INFECTIOUS WHEN THEY HAVE THE LESIONS.

SO THESE FOLKS SHOULD BE EDUCATED.

IF YOU ARE IN COLLEGE AND HAVE A SKIN RASH, LET'S CALL THE PROVIDER AND LET'S DISCUSS THESE OPTIONS.

AND IF THEY ARE FOUND TO HAVE THE MONKEYPOX, SHOULD EXPECT EVERYTHING THUD SHOULD BE ISOLATED IMMEDIATELY.

THEY SHOULD STOP CONTACT, EVEN INTIMATE CONTACT WITH OTHERS, EVEN SHEARING TOWELS OR OTHER OBJECTS WITH OTHERS AS WELL, AND TRY TO STAY HOME AS MUCH AS POSSIBLY CINCINNATI UNTIL THE INFECTION IS OVER.

SO THAT EDUCATION PART IS ALSO IMPORTANT IN ADDITION TO THE VACCINE.

BUT I BELIEVE TO BE ABLE TO HAVE OUR HANDS ON THAT MONKEYPOX, WE NEED TO PUSH MORE OF VACCINE, AND I THINK THE STATE IS DOING GREAT JOB.

WE HAVE OVER 70 PLUS CENTERS FOR THE VACCINATION, BUT I BELIEVE WE NEED TO MAKE SURE EVERYBODY IS GETTING THE VACCINE.

AND HERE I BELIEVE THE SUPPLY IS NOT AN ISSUE BECAUSE THE MODIFICATION OF THE VACCINE FROM SUBCUTANEOUS TO INTRADERMAL IS VERY HELPFUL ALLOWING PEOPLE TO TAKE MORE OF THE VACCINE SO ONE VIAL IS GOOD FOR FIVE PEOPLE AND WILL INVEES OUR CAPACITY BY FIVE BUT WE NEED TO RECALIBRATE OUR INTERVENTION.

INSTEAD OF ASKING PEOPLE PROBABLY COMING TO THE CENTER WE NEED FIND WAY TO PROBABLY DISTRIBUTE THESE VACCINES TO THESE FOLKS OR PROBABLY PUT IN IT HANDS OF ORGANIZATIONS OR PROBABLY PROVIDERS THAT HAVE CLOSE TIES TO THE LGBTQ COMMUNITY OR OTHER PEOPLE AT RISK.

I BELIEVE THIS IS HOW YOU DEYEAST OR AVOID THE STIG -- DECREASE OR AVOID THE STIGMA, BUILD FORECAST IN VACCINATIONS PROGRAM, AND YOU ASCERTAIN THAT PROGRAM OBJECTIVES HAVE BEEN A CLEVELAND.

SO WE NEED TO DO THAT.

WE NEED PROBABLY THE GOVERNMENT IS TO SHIP VACCINATIONS STRAIGHT TO PROVIDER, AND WE NEED TO MAKE THAT VACCINATION HAPPEN AS ILK WAS POSSIBLE TO PREVENT THE PARADOXICAL EFFECT MONKEYPOX.

SO MY CONCERN IS NOT TO GO TO COLLEGE OR NOT.

I EVERY PREFER THE VACCINE TO BE PUSHED AS QUICKLY AS POSSIBLE TO CREATE SOME SORT OF WALL OF IMMUNE AROUND THESE FOLKS AND THEN EVEN IF THEY GO TO COLLEGE, THEY'RE PROTECTED AND THEY DON'T SPREAD THE INFECTION.

>> DR. MOSSADY, YOU SAID IDENTIFICATION IS WORSE THAT COVID WHETHER IT COMES DO MONKEYPOX.

IT CUN TO FOUR WEEKS OR UNTIL THE SKIN IS RENEWED OVER THE SCABS AND THE LESIONS.

>> YEAH, I MEAN, SO IF THE PERSON HAS MONKEYPOX AND THEY HAVE TO ISOLATE UNTIL LAST SCAB HAS FALLEN OFF, AND THAT CAN BE AS LONG AS FOUR WEEKS.

AND SO THAT'S LONGER THAN OUR FIVE DAYS OF IDENTIFYING AT HOME WITH COVID.

ABSOLUTELY.

>> KENTUCKY HAS 36 CONFIRMED CASES.

WE KNOW THAT LEXINGTON HAS A FEW OF THOSE.

HAVE YOU SEEN THAT AT BAPTIST?

>> YEAH, WELL, I SAW THE FIRST CASE HERE IN LEXINGTON BY TELEHEALTH.

I THINK ONE OF THE THINGS THAT'S DIFFICULT FOR HEALTH CARE PROVIDERS IS WE NEED TO HAVE BETTER EDUCATION ON HOW IT CAN PRESENT DEFINITELY IT.

DOESN'T JUST PRESENT CLASSICALLY LIKE THE PICTURES YOU SEE THAT LOOK LIKE SMALLPOX IN AFTERNOON CAW.

SOMETIMES THE PATIENT WILL JUST HAVE ONE OR WOULD LESIONS IN GENITAL AREA.

THEY CAN JUST BE A LITTLE SCAB.

THEY -- IT CAN BE BASICALLY ANYWHERE ON THE BODY, BUT AS OFTENTIMES IN THE GENITAL AREA.

THE PATIENT HAVE MANY SYMPTOMS FROM IT.

NECESSITY MAY NOT HAVE MUCH PAIN.

AND IT CAN LOOK LIKE HELPER ETIC LESION, LIKE A CIVIL ITIC LESION, LIKE AN ABRASION.

SO-SO YOU OF TO HAVE A LOW THRESHOLD TO CONSIDER TESTING FOR MONKEYPOX.

ONE OF REASONS THAT IT'S IMPORTANT TO HAVE A LOW THRESHOLD TO TEST FOR IT IS THAT IF SOMEONE HAS IT AND THEY'VE HAD CONTACT WITH OTHERS, IT'S IMPORTANT FOR THE FOR THEIR CONTACTS TO BE VACS INFLATED WITHIN FOUR DAYS BECAUSE THAT'S REALLY -- VACCINATED WITHIN FOUR DAYS BECAUSE THE LEASE THE TIME PERIOD HERE YOU'RE MORE LIKELY TO PREVENT IT IN CONTACTS THAT THE PATIENT HAS HAD.

NOW, YOU CAN GIVE THE VACCINE AFTERNOON THAT AND IT MAY REDUCE THE SEVERITY OF ILLNESS BUT IT'S NOTE GOING TO NECESSARILY PREVENT THE ILLNESS.

ONE OF THE ISSUES THAT WE HAVE IS TURNAROUND IN THE TESTING TIME.

SO IT'S A PCR TEST THAT'S DONE ON THE LESION.

THE TESTING TURNAROUND TIME HAS BEEN AROUND FOUR DAYS.

SO IF YOU REALLY WANT TO MAKE THE DIAGNOSIS BEFORE FOUR DAYS A TO GIVE SOMEONE THE KWON TECHS OF VACCINE, WE'VE GOT TO REDUCE THE TURNAROUND TIME ON THE TESTING, AND I THINK THAT'S BEAN ASSIDUOUSLY WORKED ON, BUT IT'S -- WE STILL HAVE AN ISSUE THERE.

ONE OF THE THINGS THAT I DID WANT TO POINT OUT, WE TALKED ABOUT THE MORTALITY RATE OF LAID 1 BEING AROUND 10%.

THIS LADY 2 HAS BEEN AROUND 1% IN AFRICA.

WE'RE NOT SEEING THAT MORTALITY RATE IN THE UNITED STATES.

WE'RE SEEING ONE OR TWO, MAYBE TWO PEOPLE THAT HAVE DIED FROM IT OUT OF 21,000 OR SO THAT HAVE BEEN INFECTED.

BUT JUST BECAUSE THE MORTALITY RATE IS LOW DOESN'T MEAN THAT IT'S NOT A PROBLEM BECAUSE IT CAN BE DISFIGURING, ESPECIALLY IF IT'S ON THE FACE.

YOU CAN HAVE SEVERE PERMANENT SCARS.

YOU CAN HAVE VISUAL LOSS.

IF IT'S IN THE GENITAL AREA, A LOT OF PEOPLE HAVE REPORTED EXTREME PAIN, SO ONE OF THE CASES FOR TREATMENT WITH THE ANTIVIRAL T POX IS SEVEREEAU URETHRAL PAIN.

SOME PEOPLE HAVE HAD DIFFICULTY URINATING AND HAVE HAD TO HAVE A BLADDER CATHETER PLACE DOLLARS IN AND HAVE HAD TO BE ON NARCOTICS BECAUSE OF THE PAIN.

SOME PEOPLE CAN'T DEFECATE AND THEY'VE HAD SEVERE RECTAL PAIN FROM IT.

SO THE PAIN IS REALLY KIND OF ASTONISHING WHEN YOU LOOK AT THE --IAN, WHAT YOU WOULD THINK WOULDN'T BE THAT SEVERE A PROBLEM, THE PATIENTS HAVE REPORTED REALLY BEING QUITE UNCOMFORTABLE FROM IT.

SO THAT'S SOMETHING ELSE TO KEEP IN MIND.

IT'S NOT ALL ABOUT THE MORTALITY RATE.

>> RIGHT.

AND THE TESTING TIME BECAUSE I DON'T THINK WE TALKED ABOUT THAT WHEN I SPOKE WITH YOU EARLIER ABOUT FOUR DAYS TO GET THE RESULTS.

>> I MEAN, THIS IS ANOTHER ISSUE WHERE WE ARE FUNNELING TESTING TO VERY SELECT PLACES, BUT, YOU KNOW, IF YOU EVER WANT, WE DO THE PCR IN MY LAB AND YOU'RE WELCOME TO SEND ME SAMPLES IF YOU EVER WANT IT.

AND SO I THINK, YOU KNOW, ONE OF THE THINGS THAT I REALLY WANTED TO EMPHASIZE WHAT MARK SAID, THE UNUSUAL PRESENTATION OF THE CASES THAT WE'RE SEEING IN THE UNITED STATES AND ACTUALLY KIND OF FEEDBACK INTO SOMETHING THAT -- JUST SAID.

TEAL THIS IS A BIG DNA VIRUS SO AGAIN SUPER CLUNKY COMPARED TO RNA VIRUSES THAT NEED TO MUTATE AND THIS VIRUS HAS BEEN VERY, VERY SLOW MUTATING SINCE 2017.

IT'S BEEN UNSELECTIVE PRESSURE THAT'S EXERTED BY OUR NATE IMMUNE SYSTEM AND IT'S BEEN -- THE SELECTIVE PRESSURE THIS OUR IMMUNE SYSTEM HAS BEEN PLACING ON THIS VIRUS IS ACTUALLY REDUCED ITS VIRULENCE.

IT'S VERY CLEAR THAT THIS VIRUS HAS LESS VIRULENCE THAN IT DID FIVE YEARS AGO.

AND SO THAT IS LEADING INTO THIS UNUSUAL PRESENTATION WITH VERY MILD, VERY SMALL LESIONS THAT HA PEOPLE HAVE MISTAKEN FOR A NUMBER OF OTHER THINGS, WILL YOU PLUS IT'S ONE OF THOSE SITUATIONS WHERE YOU'RE JUST NOT THINKING ABOUT MONKEYPOX.

SO I THINK THE MESSAGING AROUND INCREASED AWARENESS, ALSO FOR THE MOST PART IF YOU LOOK AT THE TYPE OF SYMPTOMS THAT COME WITH THE PRESENTATION, WITH A RASH, THERE IS THIS PERIOD.

THERE IS PAIN.

THERE'S -- >> WHEN YOU SAY PRO DETERMINE PERIOD, WHAT DO YOU MEAN?

>>NESS THE PERIOD WHERE THE PATIENT IS NOT FEELING GREAT AND IT PRECEDES THE APPEARANCE OF A RASH, AND SO EVEN IF IT'S MILD, IF IT COMES WITH THIS MALAISE, THIS FEVER, THIS SWOLLEN LYMPH NODES, ALL OF THAT PUT TOGETHER FOLLOWED BY THE APPEARANCE OF SOMETHING THAT EVEN IF IT LOOKS LIKE A PIMPLE THAT WAS NOT THERE, IF YOU HAVE HAD THIS PROLONG PERIOD OF MOOLAS THIS SHOULD BE A WARNING SIGN.

SO I THINK WE NEED TO IMHAVE PRO OUR MESSAGING.

WE NEED TO MAKE PEOPLE MORE AWARE OF WHAT TO WATCH OUT FOR.

AND THAT'S BOTH FOR PATIENTS, PATIENTS AS WELL AS HEALTH CARE PROVIDERS.

>> WE DON'T SEE THIS AS BEING THE NEXT COVID.

>> OH, ABSOLUTELY NOT.

WE HAVE TWO APPROVED VACCINATION.

WE HAVE ANTIVIRALS.

WE HAVE MONOCLONAL ANTIBODIES.

WE HAVE THE ENTIRE TOOLBOX.

I THINK THE ROLL-OUT WAS A LITTLE BIT CLUMSY BECAUSE A LOT OF COUNTRIES, ESPECIALLY WEALTHY COUNTRIES, STOCKPILE THE VACCINE IN PREPARATION FOR POTENTIALLY SMALLPOX BEING USED AS A A BIOWEAPON, AND SO I THINK AT THE BEGINNING THERE WAS JUST A LOT OF CLUMSINESS.

FOR LACKAFF BETTER WORD, ABOUT ROLLING OUT THE VACCINES, RAE LEANINGS THE STOCKPILES AND GETTING ALL THAT OFF THE GROUND.

>> SO WE'LL USE THE WORD EPIDEMIC WITH MONKEYPOX.

THAT SHOULDN'T BE SCARY.

>> NO, IT SHOULDN'T BE SCARY.

THE DEFINITION AN EPIDEMIC IS AN OUTBREAK OF A DISEASE THAT IMPACTS MULTIPLE COUNTRIES.

A PANDEMIC IS AN EPIDEMIC ON STEROIDS SO IT IMPACTS EVERY COUNTRY IN THE WORLD.

>> WE'RE NOT THERE.

OKAY.

SO NOW LET'S TALK ABOUT POLIO AND THE SEVEN MINUTES AND 25 SECONDS WE HAVE REMAINING.

SO WE TALKED ABOUT THIS A FEW WEEK AGO, DR. MASSOUDY.

WHY ARE WE SEEING A RESURGENCE IN POLIO ARE AT LEAST THERE'S BEEN SOME CONNECTION WITH WASTEWATER IN NO, AND HASIT GONE BEYOND THAT?

>> RIGHT.

IT CAME TO THE FOREFRONT BECAUSE OF THIS DISCOVERY IN UPSTATE NEW YORK, IF FIRST CASE IN OVER A DECADE, PARALYTIC POLIO, AND IT HAD WAS IN AN INDIVIDUAL HOE WAS IN HIS 20s FROM A COMMUNITY WHERE WE HAVE VERY LOW VACCINATION RATES.

AND THE PARALYTIC CASE WAS CAST ABOARD THE VACCINE RESTRAIN BY ACTUALLY THE ORAL VACCINE STRAIN TYPE 2.

AND THIS IS THE -- IN THE UNITED STATES WE HAVE MADE A CHOICE MANY YEARS AGO TO ONLY USE THE INACTIVATED VACCINE BECAUSE THERE'S ALWAYS A SMALL RISK WITH LIVE ATTENUATED VACCINES OF RAE VERTING TO WILD TYPE PHENOTYPE.

ALSO IF IF YOU GIVE A LIVE ATTENUATED POLIO VACCINE IT'S GOING TO BE SHED FOR MANY WEEKS AFTER THE PERSON IS VACCINATED AND CAN BE TRANSFERRED TO OTHER PEOPLE MORE NOT TRACTION VACCINATED.

IN ENDEMIC COUNTRIES WHERE PEOPLE ARE AT HIGH-RISK THIS IS A GREAT THING.

YOU CAN ACHIEVE HERD I BE MENU VIA THE LIVE ATTENUATED VACCINE STRAIN BEING SHED AND POTENTIALLY IMMUNIZING THE OTHER PEOPLE IN THE COUNTRY, BUT THIS BECOMES DANGEROUS WHEN YOU HAVE VERY LOW VACCINATION RATES SO IT'S GREAT WHEN YOU GO ON A MASS VACCINE CAMPAIGN BUT IT'S DANGEROUS WHEN YOU HAVE NOSILY UNVACCINATED INDIVIDUALS.

SO THIS REALLY IS INTERESTING BECAUSE THIS HAPPENED IN NEW YORK BEFORE THERE WAS POLIO VACCINE, THE SAME GENETIC, SO AGAIN ABSOLUTELY RELATED STRAIN DISCOVERED IN LONDON AND BEFORE THAT IT WAS IN ISRAEL.

IN ISRAEL THERE IS NO TYPE 2 ORAL POLIO VACCINE BEING USED AT ALL, SO CLEARLY AN IMPORTED CASE.

AND IF YOU THINK ABOUT IT, JERUSALEM, LONDON, NEW YORK, HIGH TRAFFIC, HIGH TRAVEL DESTINATION AREAS, SO UNCLEAR WHERE THIS CAME FROM.

WE DO KNOW THAT THERE ARE STILL TWO COUNTRIES THAT ARE ENDEMIC FOR POLIO THE IN WORLD, AFGHANISTAN AND PAKISTAN.

SO WHERE IS THAT COMING FROM AND HOW DID IT LAND HERE?

BUT IT'S CONCERNING NOW BECAUSE IT CONTINUES TO SPREAD, IT CONTINUES TO BE DETIC AFFECTED IN THE WEAR THE WAFT SO THE GOVERNOR OF NEW YORK DECLARED AUN PUBLIC HEALTH EMERGENCY ON FRIDAY BECAUSE IT'S CONTINUED TO BE DETECTED IN NEW COUNTIES, AND FOR EVERY CASE OF PARALYTIC POLIO THERE'S HUNDREDS OF PEOPLE WHO ARE INFECTED.

THEY'RE JUST NOT SHOWING SYMPTOMS.

I THINK IT'S JUST PEOPLE HAVE FOR GONE WHAT THIS DISEASE IS LIKE, SO I DIDN'T SHARE THIS WITH YOU WHEN I MET YOU LAST TIME BEAUT MY AUNT HAD POLIO AND SHE'S PARAPLEGIC AND SO TO ME THAT WAS ACTUALLY ONE OF REASONS THAT I GOT INTO INFECTIOUS DISEASES, WAS WATCHING HER STRUGGLE WITH DAILY LIFE, AND I THINK PEOPLE JUST HAVE FORGOTTEN WHAT VACCINES HAVE DONE FOR US, AND NOBODY WANTS TO GO BACK TO KIDS IN IRON LUNGS, BUT IF WE DON'T KEEP UP WITH OUR VACCINE WITNESS WE'RE GOING TO START SEEING RESURGENCE OF DISEASES THAT WE THOUGHT WE CONQUERED.

AND SO THERE'S MULTIPLE LAYERS TO THIS.

THERE'S TRAVEL.

SO, OF COURSE, NOW INFECTIOUS DISEASE KNOWS NO BORDERS BECAUSE WE TRAVEL EVERYWHERE.

SECOND OF ALL, THE PANDEMIC HAS CUT DOWN ON WELL CHECK VISITS.

PEOPLE HAVE NOT SEEN THEIR PROVIDER UNLESS THEY ARE REALLY, REALLY SICK AND REALLY HAD TO, SO I THINK A LOT OF KIDS HAVE FALLEN OFF THEIR SCHEDULED.

I CAN'T FULLY UNDERSTAND WHY, BUT WE HAVE THIS GROWING SENTIMENT OF ANTISCIENCE AND ANTIVACCINE THAT WE NEED TO COMBAT.

AND SO IF YOU ADD ALL THESE LAYERS ON TOP OF ONE ANOTHER, THEN IT'S NOT SURPRISING THAT WE'RE FINDING OURSELVES TALKING ABOUT SOMETHING THAT WE THOUGHT WAS A RELIC OF THE PAST.

>> DR. FADI, WHEN I TALKED TO DR. MESSAOUDI ABOUT THIS, I SAID WHAT'S NEXT?

RICKETS AND SCURVY RESURGENCE?

THERE IS A POINT WHERE YOU ARE CONCERNED ABOUT WHAT IS GOING TO COME FROM CENTURIES OLD THAT WE THOUGHT WE HAD COMPLETELY OR VIRTUALLY ERADICATED.

>> LET ME TALK A LITTLE BIT ABOUT THAT CAUSE BECAUSE THAT CASE HAPPENED IN ROCKLAND, NEW YORK WHICH IS A ORTHODOX JEWISH COMMUNITY, AND IF YOU REMEMBER PROBABLY A FEW YEARS AGO IN I THINK 2019 HE HAD THIS HAD A LUGE OUTBREAK MEASLES AND GOING BACK TOOT TONIGHT WE HAVE SEEN A LOT OF ANTI-VACCINE MOVEMENTS TRYING TO PORTRAY THE VACCINES AS HARMFUL METHODS OF PROVIDING IMMUNITY, AND DISSEMINATING A LOT OF FEAR AROUND THE VACCINE, AND THIS IS THE PRICE PEOPLE ARE PAYING IF THIS DOUGH FOLLOW THE VACCINE PROTOCOLS BECAUSE THIS IS VERY TRAGIC TO SEW A CASE OF PARELYTIC POLIO WHEN THIS ASSESS THE PREVENTABLE.

SO YOU GET THE THREE FOUR DOLLARS ON-SHOT YOU'RE AT 100% I POLLUTANT ESPECIALLY AFTER 2000.

WE CURRENTLY USE THE INACTIVATED POLIO VACCINE WHICH IS BASICALLY SHOTS THAT CAN BE GIVEN TO KIDS AS WELL AS ADULTS AND ALSO YOU CANCH KOPPE ON THE VACCINE IF YOU MISSED SOME VACCINES IN PAST.

SO THIS DISEASE IS VERY PREVENTABLE.

WE HAVE ENCOURAGED PEOPLE TO GET VACCINATED AND BE ON THE TOP OF THEIR VACCINATION TO BE ABLE TO PREVENT COMPLICATIONS AND INFECTIONS IN THE FUTURE.

>> SO I'M GOING GIVE YOU THE LAST WORD, DR. DOUGHERTY, ABOUT JUST THE STATE VACCINES AND TO THE QUESTION ABOUT THOSE WHO ARE EITHER RELUCTANT OR DENY HERRY OF EDUCATION ALTOGETHER.

WHAT WOULD YOU SAY?

>> WELL, I THINK IT'S PRETTY OBVIOUS.

WHEN YOU HAVE UNVACCINATED POPULATIONS, YOU HAVE RESURGE ESSENCE OF OLD DISEASES THAT WE THOUGHT WERE CONQUERED.

THERE'S YOUR ANSWER.

AND, YOU KNOW, WHEN WE TALK ABOUT POLIO AND MEASLES, MEASLES IS ONE OF THE MOST EFFECT OF VACCINES THAT'S EVER BEEN DEVELOPED.

IT'S ONE OF THE MOST HIGHLY CONTAGIOUS DISEASES KNOWN TO MANKIND'S, AND IT ALSO COMES WITH VERY SERIOUS CONSEQUENCES AND SIDE EFFECTS OF THE DISEASE ITSELF, THE POTENTIAL SIDE EFFECTS OF THE VACCINE ARE VERY LOW.

BUT YOU CAN HAVE MEASLES ENCEPHALITIS AND PERMANENT BRAIN INJURY FOR THE REST OF YOUR LIFE AND A SIGNIFICANT PROPORTION OF KIDS WHO GET MEASLES.

SO WE NEED TO LOOK AT THE RISK/BENEFIT RATIO AND I THINK UNFORTUNATELY SOME RARE SIDE EFFECTS, RARE POTENTIAL SIDE EFFECTS HAVE BEEN REALLY OVEREMPHASIZED AND SOMETIMES PROBLEMS THAT ARE NOT EVEN REMOTELY RELATED TO THE VACCINE HAVE BEEN ATTRIBUTED TO VACCINES AND THEN THAT MAKES PEOPLE SCARED, RELUCTANT AND THEY'RE NOT WEIGHING THE RISKS VERSUS THE BENEFIT BEING VACCINATED OR UNVACCINATED APPROPRIATELY.

>> WELL, I HOPE THIS CONVERSATION DID SOME GOOD TOWARD THAT AND WE'LL KEEP DOING IT.

I THANK YOU, ALL THREE OF YOU FOR BEING HERE AGAIN.

MAYBE WE'LL RAE ASSEMBLE BEFORE THE END OF THE YEAR OR SHORTLY AFTER 2023 WHEN WE RING THAT IN WHICH IS HARD TO BELIEVE WE'RE EVEN SAYING THAT.

THANK YOU FOR WATCH TONIGHT.

WE WILL BE TALKING ABOUT A LOT ABOUT COVID AND MONKEYPOX AND POLIO AND THE FLU ON "KENTUCKY EDITION" THAT COMES ON 5:30 EASTERN, 6:30 CENTRAL AND, OF COURSE, BILL BRYANT AND A TAKENLY OF WORKING JOURNALISTS WILL DISCUSS THE NEWS OF THE WEEK ON FRIDAY NIGHT AT 8:00 EVEN, 7:00 CENTRAL TIME.

THANK YOU VERY MUCH FOR WATCHING "KENTUCKY TONIGHT."

THE WE WILL NOT BE ON NEXT WEEK.

WE ARE PREEMPTEDY FOR A KEN BURNS SPECIAL DOCUMENTARY ABOUT THE HOLOCAUST THAT WE DO HOPE YOU WILL TUNE IN AND WATCH FOR THREE ORE FOYER DAYS NEXT WEEK.

I'LL SEE YOU TOMORROW NIGHT ON "KENTUCKY EDITION."

IN THE MEANTIME TAKE GOOD CARE.